Doctor Name: | KERRY L TROUT |
NPI Number: | 1083776892 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CDP |
License Number: | CP00001561 |
Business Practice Address: | 720 W Court St 8 Pasco, WA - 99301 |
Business Phone Number: | 5095286759 |
Business Fax Number: | 5095440957 |
Mailing Address: | Po Box 1323, 515 W Court St PASCO |
State: | WA |
Postal Code: | 99301 |
Phone Number: | 5095472204 |
Fax Number: | 5095428836 |
NPI Enumeration Date: | 12/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CP00001561 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |